How much 'lived experience' is enough? Understanding mental health lived experience work from a management perspective

The Wisdom of Hindsight: Allies Reflections on Their Role in Supporting the Implementation of Expert by Experience Positions in Academia

Experts by experience involvement in mental health education has consistently demonstrated positive attitudinal outcomes including a greater appreciation for recovery-focused practice. Mental health academic allies have played a crucial role in supporting implementation of expert by experience academic positions. To date the inclusion of their views in research is limited. The aim of this study was to explore and present allies' reflections on their involvement in supporting expert by experience academic roles in relation to "hindsight" and "foresight." A qualitative descriptive design was used, involving in-depth semi-structured interviews with allies who had supported the implementation of academic roles for experts by experience. Participants described the wisdom of hindsight. Based on their own experiences they emphasised the importance of, laying the groundwork, facilitating a supportive environment, contributing to meaningful, credible, and sustainable roles, and vision for the future as key to successful implementation. They also described a vision for the expansion of expert by experience roles in mental health education in the future. Allies' reflections suggest the importance of preparation to facilitate a smooth as possible implementation process and enhance the likelihood of successful outcomes. The transition to recovery-focused mental health services requires the attitudes of health professionals to change. The potential of experts by experience to influence attitudinal change can be enhanced by understanding the experiences and reflections of academic allies.

Managers as peer workers' allies: A qualitative study of managers' perceptions and actions to involve peer workers in Norwegian mental health and substance use services

BACKGROUND

Citizens with experience and knowledge about what it is like to use mental health and substance use services are increasingly employed within similar services as peer workers. Peer workers are portrayed as achieving societal obligations and help ensure that the outputs from service provision are more effective. Even though peer workers have worked in mental health and substance use services for a while, few studies have focused on exploring managers' experiences and perspectives about involving peer workers. This knowledge is needed because these managers can enable and hinder equitable involvement and collaboration with peer workers.

METHODS

A qualitative explorative study was chosen to explore the following research question: How do managers in Norwegian mental health and substance use services experience, relate to, and embrace peer workers as assets in these services? A researcher (Ph.D. student) and a coresearcher (peer worker) conducted four online focus groups with a strategic selection of 17 Norwegian mental health and substance use services managers who had some experience with the involvement of peer workers in their organizations.

RESULTS

The results identified using systematic text condensation are as follows: [1] Peer workers boost the ongoing shift toward increased service user involvement. [2] Peer workers are highly valued in the service transformation process. [3] Managers involve peer workers as partners in co-creation. The results show that managers connect with peer workers and facilitate their involvement in collaborative activities across the service cycle. Peer workers' proximity to service users and bridging capacity is highlighted as the reasons for their involvement. Thus, peer workers are involved in co-defining challenges, co-designing potential solutions, co-delivering those service solutions, and, sometimes, co-assessing service solutions to rethink and improve services. As such, peer workers are considered partners in co-creation.

CONCLUSION

As managers involve peer workers, they increasingly discover peer workers' value, and because peer workers are involved, they increase their skills and capacity for collaboration. This research strengthens the knowledge base of the perceived value of peer workers' roles, bringing in new perspectives from management about utilizing and evaluating peer worker roles.

Peer Workers in Co-production and Co-creation in Mental Health and Substance Use Services: A Scoping Review

People with lived experience of mental health challenges are extensively employed as peer workers within mental health and substance use services worldwide. Research shows that peer workers benefit individuals using such services and can have essential roles in developing recovery-oriented services. However, understanding how peer workers' contributions, by their role, functions, and input can be better used remains a critical challenge. Research on public sector innovation has focused on relevant actors collaborating to tackle complex demands. Co-production and co-creation are concepts used to describe this collaboration. Co-production refers to the collaboration between providers and users at the point of service delivery, whereas co-creation refers to collaboration starting in the early service cycle phases (e.g., in commissioning or design), including solution implementation. We overviewed research literature describing peer workers' involvement in mental health and substance use services. The research question is as follows: How are peer workers involved in co-production and co-creation in mental health and substance use services, and what are the described outcomes? A literature search was performed in 10 different databases, and 13,178 articles were screened, of which 172 research articles describing peer workers' roles or activities were included. The findings show that peer workers are involved in co-production and function as providers of pre-determined services or, most often, as providers of peer support. However, they are rarely engaged as partners in co-creation. We conclude that the identified peer worker roles have different potential to generate input and affect service delivery and development.

Informing and Sustaining Participation of Lived Experience in the Suicide Prevention Workforce

BACKGROUND

Currently, there is no comprehensive study focused on identifying what is needed to support ongoing participation within the suicide prevention lived experience workforce (LEW). It is unclear what specific factors may impede or support ongoing participation in the LEW. The aim of this study was to explore the experiences of suicide prevention LEW in terms of its sustainability.

METHOD

A qualitative interview method was utilised, with a purposive sample of participants who had engaged in the LEW for at least 12 months. The sample comprised 13 individuals (nine females, four males) who engaged in multiple LEW roles, with over half (54%) working in the LEW for more than 5 years. Data were analysed using thematic analysis.

RESULTS

Five main themes were identified: support, passion, personal impact, training, and work diversity. Each theme offers perspectives about the challenges participants face within the suicide prevention LEW.

CONCLUSION

Challenges faced are both similar to those found in the broader MH sector and unique to suicide prevention. Findings suggest that managing expectations of the LEW is important and can inform the creation of guidelines for a supported and sustainable suicide prevention LEW.

The impact of peer support work on the mental health of peer support specialists

Background

Peers support specialists have positive impacts on the mental health of their service users. However, less is known about how their mental health changes as a result of their activities.

Methods

We followed 10 peer support specialists over their first year of employment and interviewed them thrice. We used grounded theory to analyse the way in which the health of participants changed.

Results

Self-reported mental health of our participants did not change over the course of the study. However, the role did help participants grow and learn about their condition and their strengths. While sharing their past experiences could be taxing, they learned how to harness their recovery journey without risking relapse.

Conclusion

Entering the role of a peer support specialist does not appear to negatively impact mental health, but might enhance insight and resilience. However, this appears to occur in individuals who already possess an inclination toward introspection.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13033-022-00561-8.

Embedding lived experience into mental health academic research organizations: Critical reflections

Background

As part of a growing emphasis on engaging people with lived experience of mental health conditions in mental health research, there are increasing calls to consider and embed lived experience throughout academic research institutes. This extends beyond the engagement of lay patients and also considers the potential roles of academic researchers with lived experience. When the lived experience of academic researchers is applied to academic work, there is the potential to improve the relevance of the research, while destigmatizing mental illness within academia. However, there are different and often contrasting perspectives on the way a lived experience academic researcher initiative should be implemented.

Objectives

This article describes some of the key issues to be considered when planning an initiative that leverages and values the lived experience of academic researchers, including the advantages and disadvantages of each potential approach.

Discussion & Recommendations

Institutions are encouraged to reflect on the ways that they might support and value lived experience among academic researchers. In developing any such initiative, institutions are encouraged to be transparent about their objectives and values, undertake a careful planning process, involve researchers with lived experience from the outset and consistently challenge the stigma experienced by academic researchers with lived experience.

Patient or Public Contribution

Multiple authors are academic researchers with lived experience of mental health conditions.

A Qualitative Study of the Experience of Peer Workers in the Czech Republic

The study deals with the employment of people diagnosed with mental illness in the position of peer worker. The aim is to demonstrate through semi-structured interviews the involvement of peer workers in the social services for people diagnosed with mental illness and to identify the influences that affect the success of peer workers involvement in services. The results of the interviews were divided into two categories (Position Specifics, Ethical Aspects) and four subcategories (Professionalism, Risk Moments, Stigmatization, Shared Values) using the Coding Method. The individual subcategories were further subdivided in detail. The results show that the most negative influence on the successful involvement of peer workers is the unclear definition of the job role and responsibilities and further, from an ethical point of view, it is the fear of subsequent labelling (stigmatization) in the search for a new job. A positive ethical influence is the sharing of social values (hope, recovery, friendship, sharing, etc.), which supports the peer worker. The study could help anchor the role in practice and could be the basis for further research in human resources management, social work and management.